Optimal site for atrial lead implantation in myotonic dystrophy patients: the role of Bachmann's Bundle stimulation.
OBJECTIVE
The aim of this study was to identify the optimal site for atrial lead implantation in myotonic dystrophy type 1 (MD1) patients.


METHODS
The atrial pacing lead was positioned in the high-lateral right atrial wall (site A), then in the right atrial appendage (site B), and finally on the interatrial septum (site C) in 22 patients. Pacing and sensing thresholds were obtained for all sites. The lead was repositioned and fixed at the optimal site, defined as the location with the lowest pacing and the highest sensing thresholds.


RESULTS
Mean pacing thresholds were 1.46 +/- 0.32 V at site A, 1.45 +/- 0.33 V at site B, and 0.84 +/- 0.24 V at site C. P-wave amplitude was 1.52 +/- 0.45 mV at site A, 1.52 +/- 0.49 mV at site B, and 2.60 +/- 0.48 mV at site C. Atrial lead was implanted at site C in all patients without complications.


CONCLUSIONS
Interatrial septum in the region of Bachmann's Bundle seems to be the optimal site for atrial lead implantation in MD1 patients.
Nigro
Gerardo
G
Chair of Cardiology, Second University of Naples-Monaldi Hospital, Naples, Italy.
Russo
Vincenzo
V
Vergara
Pasquale
P
D'Andrea
Antonello
A
Di Gregorio
Grazia
G
Politano
Luisa
L
Nigro
Giovanni
G
Calabrò
Raffaele
R
D000328:Adult; D004567:Electrodes, Implanted; D005260:Female; D006325:Heart Atria / Q000601:surgery*; D006333:Heart Failure / Q000175:diagnosis* / Q000517:prevention & control*; D006801:Humans; D008297:Male; D009223:Myotonic Dystrophy / Q000175:diagnosis* / Q000628:therapy*; D010138:Pacemaker, Artificial; D019919:Prosthesis Implantation / Q000379:methods*; D016896:Treatment Outcome